A course on Liver Detox with Natural Therapies

Dietary sugar consumption, in particular sugar-sweetened beverages and the monosaccharide fructose, has been linked to the incidence and severity of non-alcoholic fatty liver disease (NAFLD). Intervention studies in both animals and humans have shown large doses of fructose to be particularly lipogenic (fat forming).1

Although nutritional therapeutic approaches are required for preventing and the treatment of non-alcoholic fatty liver disease, continuous nutrition therapy is difficult for many patients because of their dietary habits and lifestyle, and because the motivation for treatment differs among patients. Successful nutrition therapy requires patient education, based on assessments of individual nutrients, and continuing the treatment.2

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. The mechanisms of the underlying disease development and progression are awaiting clarification. Insulin resistance and obesity-related inflammation status, among other possible genetic, dietary, and lifestyle factors, are thought to play the key role. There is no consensus concerning the pharmacological treatment. However, the dietary nutritional management to achieve weight loss is an essential component of any treatment strategy. 3

The Liver Ecosystem

Nature is generous. Nature is stingy. Nature creates ample reserves. Nature is a hard taskmaster. Nature is forgiving. Nature is unforgiving. Those are all aspects of nature’s grand plan of economy. In matters of human health, next to the bowel, the liver is the most glorious mirror of nature’s sense of economy.

The liver weighs two and one-half to three pounds in weight, yet it is the primary detox and metabolic organ of the body. It not only nourishes 50-100 trillion cells in the body, it is also responsible for keeping them clean and healthy. Thus, it comes as no surprise that the liver is the most frequently stressed organ of the body. One of the many wonders of nature is enormous functional reserve of the liver. When 90% of the liver mass is removed in dog experiments, the dogs stay healthy. In my biopsy work, I was more impressed by the regenerating capacity of liver cells than that in any other organ.

The ancient Greeks understood the liver’s astounding ability to regenerate. To punish the titan Prometheus for his transgression, the supergod Zeus had him chained to a mountain and sent an eagle to lunch at the prisoner’s liver. Prometheus did not do too badly, however, as far as his liver was concerned. The liver grew back every day by the time the eagle returned.

Mother Nature has designed the liver in a most extraordinarily loving way. It has bestowed upon it a rare distinction: the liver gets its oxygen and nourishment from two sources. One face of each liver cell fronts oxygen-rich blood from the heart; the other is covered with nutrient-rich blood from the bowel. To fully appreciate nature’s benevolence, one needs to recognize that arterial blood from the heart brings 40 to 50% of the required oxygen, while that from the bowel delivers 50 to 60% of the liver’s oxygen supply. That remarkable fact explains why pathologists rarely see liver infarction (large areas of cell death). The liver cell has yet another face that fronts ultramicroscopic bile passages.
The dual blood supply to the liver is a master stroke of nature’s infatuation with Dr. Jekyll/Mr. Hyde architectural designs. The blood from the bowel not only brings nutrients and oxygen, but also a payload of natural and synthetic toxins, chemicals, and toxic metals. It is the responsibility of the liver to rid the entering blood of all toxic organic acids as well as other toxins before the blood can spread them toxins throughout the body.

Liver Detoxification

It is one of the profound ironies of prevailing drug medicine that there is no concept of liver detox among liver specialists. Treatment of most liver diseases in the hands of gastroenterologists and hepatologists is confined to the use of immune-suppressive therapies, such as steroids, chemotherapy drugs, large doses of agents such as interferon, or liver transplants. Otherwise, medical texts recommend “supportive treatment,” which is a euphemism for symptom suppression with drugs. In most patients with nutritional, ecologic, immune, and heavy metal toxicity disorders, liver blood tests are often considered “within normal limits,” and no attempt is made to prescribe nutritional, herbal, and natural detox therapies.

In contrasts to gastroenterologists and internists, naturopaths nearly all develop an abiding lifelong interest in this organ. That is so because the use of liver-friendly nutrients, herbs, and liver detox is emphasized as the core strategy in their schools. They recognize the clinical benefits of liver detox therapies, not only in patients with known liver diseases but also with chronic immune, nutritional, and ecologic disorders. Many of them are awkward in describing their concepts of the structure and function of the liver. And yet, their clinical results are superior to those obtained with drug therapies, except in cases of advanced liver failure.

The Liver Has a Guardian Angel: the Bowel

The above statement is based on my work in surgery, pathology, and integrative medicine over four decades. As a pathologist, I examined more than 14,000 bowel biopsies, 5,000 stomach biopsies, and 2,000 liver biopsies. In my clinical work, I have cared for about 10,000 patients with chronic health disorders. I realized some individuals recovered from chemical and microbiologic liver injury expeditiously while others developed long-lasting liver disorders. I also recognized people in the latter group suffered from mold allergy, adverse foods reactions, prolonged bowel transit time, increased bowel permeability, and altered gut microbiota. Those observations led me to conclude a robust alimentary tract guards the liver against indolent liver injury. Those observations also led me to propose the schema of the Pyramid of Trios of the Human Ecosystem.7,8

The study of urinary excretion of hippuric acid offers an unusual opportunity of exploring the relationships between the bowel and liver ecosystems for four reasons:

(1) it is produced in the liver by a conjugation detox reaction (of benzoate with glycine) and so reflects the efficiency of this detox pathway;

(2) benzoate is produced in the gut by bacterial deamination of the amino acid phenylalanine and so reflects the state of the bowel ecology;

(3) benzoate is present in many food preservatives and give an indication of total chemical load borne by the liver

(4) pantothenic acid is the rate-limiting factor in its production and so gives an estimate of the nutritional status of the individual.

For these reasons, I examined the relationships between increased urinary excretion of hippuric acid and increased urinary excretion of seven bowel-derived mycotoxins in 135 patients (Table 1). Note that increasing values for urinary excretion of hippuric acid generally correlate with increased excretion of mycotoxins, indicating impaired ability of the liver to effectively cope with increased mycotoxin load produced by altered gut microbiota. It also furnishes biochemical evidence of my view that the bowel serves as the guardian angel of the liver.

From the Bowel to the Brain

The sick have a way of crystallizing the truth about sickness. A fibromyalgia patient once remarked,”Dr. Ali, for me it’s bowel to the brain. I eat and I get brain-fogged.” I cannot think of a more succinct and elegant way of stating the essential protective role of the liver. Medical students are taught the same thing in many convoluted ways. (Perhaps that’s why they cannot seem to retain it when they leave medical schools.) In the medical jargon, when the liver fails and toxins bypass it to reach the brain, the problems of mood, memory, and mentation are designated as hepatic encephalopathy. It is regrettable that so many physicians laugh at the concept of liver detoxification and readily label the patients hypochondriacs when they suffer liver toxicity. If the liver were not to filter the blood of its toxins and the blood from the bowel were to hit the brain directly, everyone would be brain-fogged at all times. I present this subject at length in Oxygen and Aging (2000).

CASTOR-CISE: A TIME FOR HEALING

Once all indigenous cultures had healing rituals which provided people with purpose and structure for physical and spiritual renewal. A language of silence was an integral part of most rituals. We now live “fast.” What the benefits are of the time saved is unclear to me. Those healing rituals have fallen victim to the pace of modern life. Today we need healing rituals far more than ever. In clinical medicine, I recognize the absolute need for regular periods of physical and spiritual renewal that include the language of silence, physical exercise, and detoxification measures.

We live in the age of toxic environment, toxic foods, and toxic thoughts. These toxicities create a state of molecular and cellular burn-out. From the evolutionary perspective of oxygen/inflammation/liver dynamics presented above, it should be evident that the liver bears the brunt of such toxicities. For that reason, I consider it essential to diligently assess the health of the liver in all my patients with chronic and subacute disorders, and recommend a robust liver detox program to serve my overarching goal of restoring oxygen homeostasis

Castor-Cise is my term for an integrated program of:

(1) a castor oil liver detox based on the ancient Indian tradition;

(2) a castor oil bowel detox based on the ancient Chinese tradition;

(3) a sesame oil oral detox based on its empirical benefits;

(4) limbic, non-competitive, meditative exercise. Below, I describe my own routine of Castor-Cise three times a week. I regularly prescribe it for all my patients and strongly urge them to be innovative once they have learned the basic routine.

For most patients, I also recommend:

(1) a lemon juice-maple syrup “spicy lemonade” fluid fast once weekly, which can be done on a scheduled Castor-Cise day

(2) Dr. Ali’s breakfast five days a week (comprising two tablespoons of granular lecithin taken with two tablespoons of freshly ground flaxseed and high-quality protein powder mixed with 16 ounces of organic vegetable juice).

Dr. Ali’s Castor-Cise

On weekend mornings, of Saturdays and Sundays, I warm two tablespoons of castor oil in a large spoon by flame. I apply the oil liberally to:

(1) the liver area (the rib cage on the right side, extending from mid-line in front to the mid-line behind);

(2) the front and sides of the abdomen;

(3) shoulders

(4) lightly smear on my face.

For the next two hours, I stay in a limbic state, a meditative state free of the clutter of an unfocused mind (see The Cortical Monkey and Healing (1999).8xx I do not to use telephone, nor watch TV. Low volume music is acceptable at times. I prepare my breakfast as described above (usually 60 ounces of my protein shake) and take nutrient and herbal supplements with eight to ten ounces of the shake at a time. Intermittently, I engage in limbie exercise (gentle, meditative, non-competitive described in my book The Ghorra and Limbic Exercise.9xx I favor rebounding (jumping jacks on a rug wearing thick socks), rug-running, and light weights (ten to fifteen pounds). There is no sweating, huffing, or puffing, nor any sore muscles (crucial for a 67-year-old with much work to do). In between segments of exercise, I practice limbic breathing (see my column in July 2007 issue of the letter10) and try to be in a spiritual work (see my book The Crab, Oxygen, and Cancer11 for practical suggestions. I often work on my computer as well during castor-Cise. Writing is easier in the limbic state). At the end, I shave, shower, and get ready for the rest of my day. I begin my shower with hot water and end it with sudden burst of cold water to help maintain autonomic equilibrium. Each castor period is a free of demands of a cluttered mind.

Castor-Walk, Castor Jog, and Castor Gym

There is a difference between teachers and gurus. True teachers want their students to reach beyond their reach. Gurus do not want their disciples to escape their servitude. In the spirit of teachers, I ask my patients first to learn well Dr. Ali’s Castor-Cise and then innovate and modify the basic Castor-Cise routine to enhance its value for themselves personally. For example, one can apply castor oil before going for a walk (“Castor-Walk”), a jog (“Castor-Jog”), or a work-out in a gym (“Castor-Gym”). One can do one, two, three, or all components of Castor-Cise on any given day, depending upon availability of time, mood, or inclination. The crucial point is that each castor period is free of demands of a cluttered mind.

The LEMP Spicy Lemonade Fluid Fast

Lemon juice, maple syrup, cayenne, and Epsom salt have been used for centuries in various formulations for combined liver and bowel detox procedures. Below, I describe the adaptation which my colleagues at the Institute of Integrative Medicine, New York, and I have used for several years with empirical benefits. The procedure is simple and when done correctly (in a prayerful / meditative state) does not cause any discomfort. The old begin low-build slow principle is as applicable here as in other publications for medical education. We do not find it necessary to alter the use of prescription medications for our patients when they engage in the LEMP procedure. We do reduce by 50% the nutrient and herbal supplements during the first day the fast is done.

I do not recommend LEMP fast for periods longer than one day at a time since I have encountered adverse responses with extended fast/flushes. The amount of needed Epsom salt varies with the condition of individuals. Two to three quarts of additional water should be taken during the day. If hunger develops and becomes uncomfortable, a grapefruit may be eaten. A light vegetarian meal is suggested for the evening if hypoglycemic symptoms occur. The following is the two-part recommended protocol:

Part A: Begin in the morning and continue through the day with the spicy lemonade made up of:

(5) drink in small portions throughout the day, at your comfort level. May begin with a second 24-ounces of the above.

Part B: Begin the morning or mid-morning saline laxative with one teaspoon of Epsom salt with three ounces of water. Slowly build to one tablespoons if found necessary for complete bowel evacuation.

Repeat after one hour (One tablespoon Epsom salt with three ounces of water), if no bowel movement occurs. Repeat after one hour, if necessary.

Hypoglycemic symptoms developed uncommonly among our patients. In such cases, we recommend drinking four ounces of a protein shake (as described above) every four hours. If symptoms persist, the LEMP fast should be terminated.

Liver-Friendly Nutrients and Herbs

Lecithin is the guardian angel of the liver. I prescribe it on a five days a week basis for all my patients. Flaxseed and organic vegetable juice are my next priorities. All three are included in Dr. Ali’s breakfast. I prescribe liberal daily doses of oxystatic nutrients, including glutathione (100-300 mg), coenzyme Q10 (100 to 200 mg); methylsulfonylmethane (MSM, 750 to 1,500 mg); taurine (750 to 1,500 mg); and antioxidant vitamins. Among the minerals in elemental doses are: magnesium (500 to 750 mg), potassium (100 to 150 mg); calcium (500 to 750 mg); zinc (25 to 50 mg), and selenium, chromium, and molybdenum (400 to 600 mcg each). Among the oxystatic phtofactors are turmeric, milk thistle, goldenseal, ginger, garlic, and Jerusalem.

Direct Oxystatic Therapies

For reversing liver disease, my colleagues at the Institute of Integrative Medicine, New York, and I rely heavily on direct oxystatic therapies, such as hydrogen peroxide foot soaks, intravenous peroxide and ozone therapies, and EDTA chelation infusions. I devote extended chapters to these therapies in, Darwin, Dysoxygenosis, and Disease, 3rd. Edition (2007), the eleventh volume of The Principles and Practice of Integrative Medicine.